Action | Practice of dry needling |
Stage | Proposed |
Comment Period | Ended on 7/26/2019 |
"Dry needling" is an attempt to re-brand an existing skill set and in doing so bypass all meaningful regulation and training requirements established by state and national norms. The american medical association states in its position that Physical therapists are not qualified to provide invasive procedures like it and adds "Lax regulation and nonexistent standards surround this invasive practice. For patients' safety, practitioners should meet standards required for licensed acupuncturists and physicians." I have included information below to summarize my professional stance with data rather than simple opinion.
Topic: Practice Parameters | Policy Subtopic: NA |
Meeting Type: Annual | Year Last Modified: 2016 |
Action: NA | Type: Health Policies |
Council & Committees: NA |
Our AMA recognizes dry needling as an invasive procedure and maintains that dry needling should only be performed by practitioners with standard training and familiarity with routine use of needles in their practice, such as licensed medical physicians and licensed acupuncturists.
FURTHER INFORMATION TO SUBSTANTIATE MY FEELINGS:
HISTORY
•“Dry Needling” was originally done ONLY by physicians using a hypodermic needle to stimulate a Myofascial Trigger Pointwithout injecting a solution, like saline or lidocaine. Travell, Simons, & Simons, 1999, pp. 154–155
•Janet Travell was the first to use the term "dry needling" to differentiate between two hypodermic needle techniques when performing trigger point therapy. However, Travell did not elaborate on the techniques of dry needling; the current techniques of dry needling were based on the traditional and western medical acupuncture. Travell, Simons, & Simons, 1999, p. 156
•Myopain Seminars and other Dry Needling training companies have instructed students to use Seirin filiform needles, and to purchase them from Lhasa OMS.
DEFINED
“A skilled intervention that uses a thin filiform needle to penetrate the skin and stimulate underlying myofascial trigger points, muscular, and connective tissues for the management of neuromusculoskeletal pain and movement impairments.
-American Physical Therapy Association
http://www.apta.org/StateIssues/DryNeedling/ClinicalPracticeResourcePaper/
https://www.researchgate.net/publication/232397899_Trigger_Points_and_Classical_Acupuncture_Points
“Up to 93% of classical acupuncture points anatomically correspond with common myofascial trigger points, likely describing the same physiologic phenomena.”
DEFINED
A medical intervention performed by highly skilled, licensed acupuncturists or medical physicians that uses a thin filiform needle to penetrate the skin and stimulate neural, muscular and connective tissues for the prevention and management of pain and movement impairments.
ALSO KNOWN AS ACUPUNCTURE.
TRAINING & CREDENTIALING
EVIDENCE BASED MEDICINE
Scientific Literature
PUBMED
ACUPUNCTURE: 28,066
DRY NEEDLING: 370
DRY NEEDLING AND ACUPUNCTURE: 182
Using Biomedical Language
Strengthens the argument that acupuncture is dry needling
Enhance credibility and understanding within the medical community
DRY NEEDLING EXPERTS
THE POINTS
Myofascial Trigger Points (Ashi Points)
A sensitive area in the muscle/connective tissue that becomes painful when palpated
Motor Points
The most electrically excitable area containing the greatest concentration of nerve endings in the muscle
Eliciting a twitch releases lactic acid and calcium build up
TRAINING
FALL 2018 | MN
Lecture, Demonstration & Clinical Practice
Motor Point Location, Needle Techniques, EBM, Pt Education
PUBLIC SAFETY
The National Institute of Health warns that use of FILIFORM needles in treatment “can cause serious adverse effects, including
infections, punctured organs, collapsed lungs, and injury to the central nervous system.”
•Report all known DN adverse events
•Confirmed cases in MN of PTAs assisting PTs in treatments by removing needles
INSURANCE FRAUD
•Insurance Companies DO NOT Recognize “Dry Needling” as a Billable Charge.
•Educate and Instruct Patients on How to Report Possible Insurance Fraud
§If patients are NOT paying for “dry needling” at the time of service, it is likely that the provider is improperly billing the insurance company